| NPI | 1548724503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04503) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238320) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |